Related Coverage

BOSTON (STATE HOUSE) – Hoping to avert two costly health care-related ballot campaigns in the fall, the House on Wednesday unanimously signed off on a bill that sets nurse staffing ratios in intensive care units within hospitals.

If the bill reaches Gov. Deval Patrick and is signed into law before July 2, the proponents of two proposed ballot questions are expected to drop their campaigns. One ballot initiative would set varying nurse staffing ratios in hospital units, and the other would regulate CEO compensation, annual operating margins and financial asset disclosures of hospitals and other facilities.

The bill (H 4228) now moves on to the Senate, which is expected to take up the legislation during a formal session on Thursday, according to Senate President Therese Murray’s office.

The Massachusetts Nurses Association, which had been pushing for both ballot initiatives, credited Senate Majority Leader Stan Rosenberg, an Amherst Democrat who is expected to become the Senate president next year, with initiating negotiations that led to the agreement.

“This agreement is specifically to patients in the intensive care unit, which is the critical care area of the hospital. That’s where patients need absolute constant supervision and a nurse at their ready at all times,” Donna Kelly-Williams, a registered nurse and head of the Massachusetts Nurses Association, said in an interview outside the House chamber after the vote. “And this provides for one patient per nurse to be right there to take care of those patients at the most critical time of their life when they’re hospitalized in an intensive care unit.”

She added that more nurses could be added to a patient’s team, or if a patient requires less care and is stable a nurse could take on an additional patient.

The nurses’ association has signed off on the language in the bill, Kelly-Williams said.

Asked if the Massachusetts Hospital Association, which has repeatedly tangled with the nurses’ association over the two ballot initiatives, has also agreed to the legislation, Kelly-Williams said, “It is my understanding that they have.”

Opponents of past legislation setting nursing staff ratios, which is an issue that has roiled Beacon Hill for over 15 years, have argued that a professional caregiving team at a patient’s bedside should determine care levels, instead of a fixed formula.

Earlier in the week, the nurses association launched an ad campaign calling on state lawmakers to respond to high hospital CEO salaries and money stored in offshore accounts. The ads, which are playing on television and radio stations and are scheduled to run through July 2, show a pair of hospital CEOs toasting glasses of champagne on a Cayman Islands beach.

The Massachusetts Hospital Association had hit back, calling the ad “misleading and irresponsible” and saying in a statement that the nurses association “represents a small minority of registered nurses.”

Noting that ballot campaigns tend to be grueling and expensive affairs, Rep. George Peterson (R-Grafton), the assistant minority leader, said the proposed agreement saves “everybody a lot of money, pain and agony.”

The bill, which passed the House with no debate, sets up patient-nurse ratios of one nurse to one patient, or one nurse to two patients, “depending on the stability of the patient as assessed by the acuity tool and by the staff nurses in the unit, including the nurse manager or the nurse manager’s designee when needed to resolve a disagreement.”

Under the bill, the so-called “acuity tool” will be developed and chosen by each hospital in consultation with the staff nurses and the other medical staff, and shall be certified by the state Department of Public Health. The Health Policy Commission, an independent body, would regulate the implementation of the proposed law, including the formulation of the “acuity tool”, the method of public reporting of staffing compliance in hospital ICUs, and the identification of three to five patient safety quality indicators.

The bill, which only emerged Wednesday, advanced in the House through a maneuver that included a portion of another bill calling on the state Department of Public Health to administer a “folic acid awareness initiative.” Folic acid is a type of vitamin.

The final version of the legislation passed by the House includes both the folic acid initiative and the nurse staffing language.